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What’s a father to do when patients’ rights laws and bureaucratic inattention put his mentally ill and sometimes dangerous son on the streets?
Drew Haldane, the subject of this story, wrote and recorded a collection of songs that attracted the attention of his high school classmates. “This Is For You,” written in late 2005 just months before his first serious breakdown, speaks of his hope in the face of despair.
The call I feared finally came late on a Friday. I was at the edge of sleep in my Los Alamitos condo when a ringing phone jolted me back into consciousness. I got my bearings, and sat up straight. Oh God, I thought, It’s finally happened.
The voice on the other end offered little comfort. “I’m a nurse at Hollywood Presbyterian Hospital,” she said. “Don’t panic, but we have your son.”
Mentally ill and virtually homeless at 24, Drew had been in danger for some time. Now he was in the hospital’s intensive care unit with a serious blow to the head. Exactly how it happened was unclear, the nurse said; she believed he’d been in a fight. Whether there was brain damage, and to what extent, only time would tell.
My mind reeled. I had imagined this conversation, or variations if it, many times. Now I rubbed my eyes, put on some clothes, and looked for the car keys.
Just eight weeks earlier, the media were filled with stories about Kelly Thomas, another homeless, mentally ill young man who bore a striking resemblance to my son. Thomas, who like Drew suffered from bipolar disorder and schizophrenia, was too slow responding to a police interrogation on the streets of Fullerton. In an alleged crime for which three former officers are set to appear this month and stand trial next year, Thomas was beaten and ended up in a coma. Five days later, without regaining consciousness, he died.The story had filled me with dread, because it could so easily have been Drew.
“I’ll be there as soon as I can,” I told the nurse, and hung up the phone.
My boy hadn’t always inspired calls in the night. Once he was a bright kid with thick blond hair, a winning smile, and what seemed like a limitless future. Then things started going wrong. He was arrested for setting fire to a trash can, stole candy from a liquor store, and ran away from home. We first thought these were teenage shenanigans. Had we paid closer attention to the poems he began to write, we might have had an inkling of what was to come.
Drew always had a great imagination. In elementary school he entertained classmates with tales of a mysterious character named Carlos whom only he could see, but who supposedly made impromptu visits to the playground. He also had trouble focusing in class, a problem counselors blamed on attention-deficit (hyperactivity) disorder. Not yet aware of the true nature of Drew’s illness, they recommended Ritalin, a commonly prescribed medication promising an easy cure.
So we dutifully fed him little yellow pills between weekend surfing excursions to Seal Beach and summer vacations at Yosemite Falls. They didn’t work; Drew fell behind, eventually landing at Los Alamitos’ Laurel High School, a continuation program with just over 100 students. The place seemed a godsend. And for a time, under the tutelage of a caring teacher, Drew was reborn.
Writing poetry soothed him. Love is like oxygen, one read. Too much you get too high; not enough you’re gonna die. Later the themes grew darker. To all the people who love me, I’m sorry to make you frown. But this sadness that becomes me, it will always bring me down.
He rebuffed our repeated efforts to get him into therapy. Then one day Drew retired to his room and emerged two weeks later with a computer-produced CD containing a compilation of poems set to music. Though the audio was uneven, it was obvious he had talent. He scored a film shown at a student festival at Los Alamitos High School and was assigned the same task for another movie by local college students.For a few weeks my son enjoyed celebrity status on campus.
But I knew something was wrong when I got a long-distance call from his mom while I was out of town. We were divorced by then and Drew had recently moved to my house. “Are you home yet?” Dawn asked, confused. “Because Drew says he hears your voice.”
A few weeks later he drove to a construction site and nearly killed himself by drinking liquid sealant. My son spent his high school graduation day in a psychiatric ward at College Hospital of Costa Mesa—his first of many stays.
I thought of all this as I drove to the intensive care unit.Mostly I thought of Kelly Thomas, who was 37 when he died. Like Thomas, Drew had once been conserved.
In the parlance of mental health, conservatorship has a special meaning. It happens when, in the opinion of professionals backed by the court, a mentally ill person consistently presents a danger to self or others and is incapable of caring for himself. In such cases, the court assigns someone—usually a family member or professional public guardian—to act on the person’s behalf. Conservators have broad legal obligations, including to provide housing and, when necessary, to mandate treatment in a locked psychiatric facility.Conservatorship is not easy to get, and must be renewed each year.
Drew’s conservatorship was first initiated following an incident at the apartment he’d moved into after leaving my house. It was his 19th birthday and I’d promised him a new TV antenna. He opened the door immediately. “Get the hell out of here, Dad,” he said, and without further warning began pummeling me in the hall. I took the only possible course: lying limp on the floor shielding myself with elbows and praying his anger would subside. It did. He retreated wordlessly into his room, and I dragged myself to the front porch to call 9-1-1.
The police arrived in 15 minutes with just one question: Did I want to press charges? I convinced them that he needed help, not jail, and the officers took him back to Costa Mesa’s College Hospital, where he was put on a 72-hour hold. Thus the process began.
That first conservatorship lasted four years. For a while, the chaos continued; Drew was evicted from a series of board-and-care facilities for attacking other residents, was arrested on assault charges, made several more suicide attempts, and threw a large rock through his mother’s front window. Finally we got a reprieve; he was sent to a locked facility requiring that he take his meds. It wasn’t perfect, but at least we knew that he and those around him were safe.
Then disaster struck anew. As usual, the news reached me by phone, this time in the parking lot of Westminster Mall. “Are you sitting down?” Dawn asked. “Drew’s conservatorship has been dropped.”
It happened, we were told, after a psychiatrist missed three court hearings on whether it should be continued for another year. The hospital said the psychiatrist, a consultant working in a separate office, claimed “not to have gotten the fax.” In the absence of expert testimony that he was a danger to himself and others, the judge set my son free.
And so our nightmare continued.
Drew’s situation was not unusual. In any given year, according to the National Alliance on Mental Illness, roughly one in 17 Americans suffers from serious mental disease. And yet, the agency—the nation’s largest grassroots nonprofit advocacy group representing people affected by mental illness—reports that only about a third ever get treatment.
One reason is a serious lack of funding. In an era of government cost-cutting, empty beds are few. While some, like Drew, receive payments from Supplemental Security Income, a federal program to aid the aged and disabled, the money—in my son’s case about $1,000 a month—is rarely enough to cover full hospitalization. More importantly, even when space is available, many sufferers don’t believe they’re ill. And strong patients’ rights laws prohibit mental health professionals from providing unwanted care.
The exceptions are those with conservatorships.
The process by which this happens is long and arduous. Established in California by the landmark Lanterman-Petris-Short Act of 1967, conservatorship was the final step in a paradigm shift that had evolved during nearly two decades. Prior to the 1950s, most mentally ill people were treated in locked state-run hospitals. With the advent of anti-psychotic medications, however, the idea of community-based health care gradually gained sway.
By establishing guidelines regarding who could be hospitalized and requiring each case to be judicially reviewed, reformers dramatically reduced the population of state hospitals—ultimately prompting many to close. At the same time, Gov. Ronald Reagan slashed state funding for community mental health care, beginning a trend that continues today.
“Avoiding hospitalizations is a way of cutting costs,” says Steve Pitman, president of the National Alliance on Mental Health’s Orange County chapter in Santa Ana. “It’s far more likely that a mentally ill person will end up in jail.”
Or, like Drew and Kelly Thomas, in the streets.
Pulling into the hospital’s parking lot, I recalled another drive to Hollywood just days before. It had been weeks since anyone had seen Drew at the Lynwood board-and-care home to which he’d been assigned, and we were concerned. Then one day he called from what must have been a borrowed phone.
“Hey, Dad, what night is it?”
“Saturday,” I said. Then gently added: “We’re wondering where you are.”
“Working in L.A.,” Drew said without skipping a beat. “I’m at Hollywood and Orange; why don’t you and Mom visit me wearing black ties?”
The next day Dawn and I drove to the intersection Drew described. He appeared and jumped in. I had never seen him like this. Disheveled and sunburned with long hair and wild eyes, he was clearly in a hurry. “Let’s go!” our son ordered, glancing nervously behind. “You guys are in so much trouble.”
At a nearby McDonald’s, Drew clued us in: He was working undercover for the CIA, protecting the president from would-be assassins. Did he actually know the president, we inquired. Well, yes, Drew said; he’d written speeches for him and they spoke by phone. “People keep messing with me,” he complained. “The cops follow me everywhere, security guards follow me around; it’s all over the news.”
Was he still on his meds, Dawn wanted to know. “Sure,” he said. Then, incredibly: “Actually I make my own from stuff I find on the street.”
Suddenly, Drew had to go. “Got to get back to work,” he growled. “I have no time.” And we watched him disappear into the crowd.
I hardly recognized my son in the ICU at Hollywood-Presbyterian.Semiconscious with a thick bandage around his head, he barely recognized me. Shaken, I huddled with a doctor in the hallway for a full report.
Apparently Drew had returned to his board-and-care facility just long enough to pick a fight with a much-bigger resident. The man knocked him out with a single blow, literally rattling his brain and causing it to bleed. Emergency physicians considered surgery but, for the moment, ruled it out; with any luck, they believed, the bleeding would stop on its own.
“Is there brain damage?” I asked, afraid to hear the answer.
“Too early to tell,” the young doctor said. “If there is, it should be evident within a few months, based on his behavior.”
Just one problem with that: Significant behavioral changes can be hard to detect in someone as erratic as Drew. In the months leading up to this disaster, his actions became increasingly bizarre. He called us at odd hours, sometimes angry, sometimes in tears. “You have five days to live,” he told his mom in one conversation. Then later: “Dad, I don’t know what’s going on.”
Around Christmastime, Drew sent a postcard to his stepfather asking for help in getting a gun. And as his deterioration continued, so did our alarm.
Here’s how it’s supposed to work with the gravely mentally ill:The presidingpsychiatrist at a hospital to which a dangerously behaving patient has been admitted initiates conservatorship proceedings. Then, if the judge agrees, the patient is put on a waiting list for longer-term care.
How it actually works is far different: If you’re lucky enough to learn that your loved one has been hospitalized, you have 72 hours—the maximum time he can legally be held—to respond. So you get on the horn with the hospital’s social worker, fax a detailed history, and make as much noise as possible. The next day, which in our case was usually a Saturday, you learn that the social worker is off and his replacement has no idea what you’re talking about. So you fax the document again, or personally deliver it to the front office, praying that somehow it will land in the right hands. Then you get a call from your loved one saying he has been released and is back on the street.
Better luck next time.
In approximately 1½ years, Drew was hospitalized on temporary holds no fewer than 10 times. He also was involved in numerous violent altercations, frequently threatened to harm himself or others, and was evicted from four board-and-care homes. At each opportunity, Dawn and I swung into action, calling social workers and hospital administrators, faxing documents and writing letters. “We are writing,” we began one of them, “in the urgent hope of saving the life of our son.” Yet we were rebuffed or ignored every time.
At the heart of that seeming indifference are patients’ rights laws which, while enacted with the honorable intention of protecting would-be patients, often instead prevent their violence from being constrained. Orange County’s recent history is strewn with the resulting carnage.
In the summer of 2000, Marie Elise West—a mentally ill woman whose parents live in Seal Beach and who had consistently resisted her family’s attempts to have her hospitalized—killed an elderly Latino man she referred to as “road kill” by repeatedly running over him with her car. Eventually convicted of murder, she was found insane and sent to a state mental institution.
Three years later Joseph Hunter Parker, a former grocery bagger diagnosed with schizophrenia, walked into an Albertsons market in Irvine brandishing a samurai sword. Before police killed him, Parker—who had been hospitalized and released numerous times—hacked two employees to death and wounded several shoppers. And in 2004, a police standoff in downtown Huntington Beach ended in the police-assisted suicide of Steve Hills, who suffered from bipolar disorder and had been released from a hospital that morning.
In the wake of Kelly Thomas’ death, Orange County activists have urged the adoption of Laura’s Law, a rarely used state statute allowing for some court-ordered outpatient treatment. But, stymied by debate over civil liberties and costs, county officials have failed to act. And the enabling legislation expires next month. Even Laura’s Law wouldn’t solve our problem; though a judge can order someone to take meds, there’s no way to enforce it outside a locked psychiatric facility.
For Drew, things have recently taken a turn for the better: One day, in what we since have come to regard as a miracle, the heavens opened and the hand of God reached out to grab the foot of our son.
Our agony of sleepingwith one eye open ended abruptly some 17 months from its inception. Earlier this year, many months after being released from Hollywood-Presbyterian in stable condition following a six-day stay, Drew showed up at his mother’s home, pounding on the front door.
“I need money right now!” he demanded.
“Would you like us to take you to the hospital?” she suggested with the door opened only a crack.
He readily agreed, probably assuming that, as usual, he’d get a few nights of warm beds and hot meals. Dawn and her husband drove him to College Hospital of Cerritos where he was admitted on another 72-hour hold. The next day we again got on the telephone and manned the fax. This time the authorities listened.
Drew’s hold was extended and he was transferred to College Hospital of Costa Mesa where, years before, his hellish journey began. Six weeks later—on May 3—a Los Angeles County Superior Court judge ordered a one-year conservatorship by the Office of the Public Guardian. So our son is safe at least until the next renewal hearing, which we certainly plan to attend.
To be honest, I can’t tell you how much Drew understands.We try to visit him weekly at the Costa Mesa hospital where he is awaiting placement in another locked facility designed for longer stays. The first time broke my heart; in what seemed like a rare moment of clarity, he cried and asked us to pray. Then he slipped back into the fog of insanity.
Though the disease is incurable, doctors tell us that as many as half of those diagnosed with schizophrenia like Drew’s eventually can recover enough to lead relatively independent and productive lives. But it only happens when they understand their conditions, zealously adhere to prescribed medications, and devote themselves to a psychiatrist’s care.
So far we’ve seen none of that in Drew.
Visiting him is like being on a carnival ride. Sometimes the going is smooth, and then the craziness pops up to holler boo. At various times Drew has told us he is still a CIA agent protecting the president, a powerful drug dealer with millions of dollars stashed away, and a famous songwriter whose music is on TV. Once he told us he faced life imprisonment for accompanying a medical doctor to Los Angeles, where they murdered a teenager to harvest psychotropic meds from the kid’s internal organs.
Often irritable, Drew can be abusive and threatening. As bad as it gets, though, we see glimmers of the boy we love. On Father’s Day, he was the first to call. “Have a wonderful day,” he said. “Life is a gift; just unwrap it and be glad.”And when he hugs his mother, it’s with real affection.
Of course, we still wonder how all this happened. To the best of our knowledge, there is no serious mental illness in either of our families. So we go through periods of asking who is to blame. Did it start when, at the age of 3 weeks, he fell off the kitchen counter onto his head? Or is it because I never flew enough radio-controlled airplanes or took him scuba diving with me when he was a kid?
Without clear answers, we live by our phones.
Mine rang again recently with one of those calls that seem to mark the parameters of my life. “Dad,” Drew’s voice came weakly, as if from afar. “Am I going to die?”
It’s the kind of question for which you can’t prepare. I thought a moment before answering. “Not any time soon,” I told him. “Just cooperate with your doctors and you’ll improve.”
Our fondest wish is for that to be true.
This article originally appeared in the November 2012 issue of Orange Coast magazine.